Ketoacidosis Medical Terminology

Diabetes Glossary

Antibodies Antibodies are specialized proteins that are part of the immune system. They are created when an antigen (such as a virus or bacteria) is detected in the body. The antibodies bond with the specific antigen that triggered their production, and that action neutralizes the antigen, which is a threat to the body. Antibodies are created to fight off whatever has invaded the body. See also autoantibodies. Antigens An antigen is a foreign substance (such as a virus or bacteria) that invades the body. When the body detects it, it produces specific antibodies to fight off the antigen. Autoantibodies Autoantibodies are a group of antibodies that “go bad” and mistakenly attack and damage the body’s tissues and organs. In the case of type 1 diabetes, autoantibodies attack the insulin producing beta cells in the pancreas. Autoimmune disorder If you have an autoimmune disorder (also called an autoimmune disease), your body’s immune system turns against itself and starts to attack its own tissues. Basal secretion (basal insulin) We all should have a small amount of insulin that’s constantly present in the blood; that is the basal secretion. People with type 1 diabetes must take a form of insulin that replicates the basal secretion throughout the day; that’s basal insulin. Beta cells Beta cells are located in the islets of Langerhans in the pancreas. They are responsible for making insulin. Blood glucose level The blood glucose level is how much glucose is in your blood at a given time. This level is very important for people with diabetes, and they must monitor their blood glucose level throughout the day. If the blood glucose level is too high (hyperglycemia), that means that there isn’t enough insulin in the blood. If it’s too low (hypoglycemia), that mean
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Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common
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Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Throughout treatment blood sugar and potassium levels should be regularly checked.[1] Antibiotics may be required in those with an underlying infection.[6] In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended.[1][6] Rates of DKA vary around the world.[5] In the United Kingdom, about 4% of people with type 1 diabetes develop DKA each year, while in Malaysia the condition affects about 25% a year.[1][5] DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost univ
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Ketosis Vs. Ketoacidosis: What You Should Know

Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin. Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production. Ketosis is the presence of ketones. It’s not harmful. You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you have ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat. Some people choose a low-carb diet to help with weight loss. While there is some controversy over their safety, low-carb diets are generally fine. Talk to your doctor before beginning any extreme diet plan. DKA is the leading cause of death in people under 24 years old who have diabetes. The overall death rate for ketoacidosis is 2 to 5 percent. People under the age of 30 make up 36 percent of DKA cases. Twenty-seven percent of people with DKA are between the ages of 30 and 50, 23 percent are between the ages of 51 and 70, and 14 percent are over the age of 70. Ketosis may cause bad breath. Ket
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Ketoacidosis

Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal.[1] Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover.[2] Ketosis may also give off an odor, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Cause[edit] Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively.[3] In diabetic ketoacidosis, a high concentration of ketone bodies is usually accomp
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Diabetes Medical Terminology

Serious complication related to a deficiency of insulin and increase in insulin counter-regulatory hormones Enzyme that rapidly degrades active incretin hormones after they are released Normal concentration of glucose in the blood. Also called normoglycemia Stored form of glucose in the liver and skeletal muscle conversion of glycogen to glucose in the body The synthesis of glucose in the body from non-carbohydrates, such as protein or fats A value that represents the percent of hemoglobin in the blood that is glycosylated. This percent reflects the glycemic control over the past 2 to 3 months. Serious condition characterized by hyperglycemia, hyperosmolarity and dehydration and the absence of ketoacidosis that may occur in type 2 diabetes Most common acute complication of diabetes; occurs from a relative excess of insulin in the blood and is characterized by below-normal blood glucose levels A condition characterized by the abnormal accumulation of ketones in the body tissues and fluid Breakdown of fats and lipids to fatty acids (alternative fuel source) Small blood vessel disease caused by long term exposure to hyperglycemia; most commonly affects the eyes, kidneys, and nerves Large blood vessels disease; most commonly affected are the coronary arteries, the large arteries in the brain, and large arteries in the periphery A term that reflects when the kidney is allowing an abnormal amount of protein (> 30 g/mg) to be filtered through the glomerulous. Marker used in addition to serum creatinine and GFR to stage chronic kidney disease.
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Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through your vein and closely watching certain chemicals in your blood (electrolyt
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Medical Terminology - Chapter 18

Hormone secreted by the adrenal cortex; regulates salt and water balance. Male hormone responsible for developing and maintaining male secondary sex characteristics. Secreted by the posterior lobe of the pituitary gland; promotes water reabsorption by the kidney. Hormone secreted by the thyroid gland; lowers calcium levels in the blood. Hormones secreted by the adrenal medulla; epinephrine (adrenaline) is an example. Hormone secreted by the adrenal cortex; cortisol and aldosterone are examples. Hormone secreted by the adrenal cortex; regulates the use of sugars, fats, and proteins in cells. Cortisol raises blood sugar. Substance that, in solution, carries an electric charge; examples are sodium (Na+), potassium (K+), calcium (Ca++) and chloride (Cl-). Medical specialist in the diagnosis and treatment of endocrine gland disorders. Hormone secreted by the adrenal medulla; increases heart rate and blood pressure. Female hormone secreted by the ovaries and to a lesser extent by the adrenal cortex in both males and females. Pertaining to the producing of female characteristics or having the same effect as estrogen. Measures circulating glucose level in a patient who has fasted at least 4 hours. This test can diagnose diabetes mellitus. Secretion of the anterior lobe of the pituitary gland; stimulates ovarian follicles to produce egg cells. Hormone secreted by the pancreas (alpha islet cells); increases blood glucose (sugar) by conversion of glycogen to glucose. Steroid hormone secreted by the adrenal cortex; cortisol is an example. It raises blood sugar. Deficient secretion of hormones from the pituitary gland. Region of the brain lying below the thalamus, but above the pituitary gland. It stimulates the pituitary gland to secrete and release hormones. Hormone secreted by t
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Medical Terminology - Chapter 8 - Endocrine System

Triangular-shaped glands located above each kidney that secrete hormones that aid in metabolism, electrolyte balance, and stress reactions; each gland consists of an outer part called the adrenal cortex, and an inner part called the adrenal medulla Part of the brain located near the pituitary gland that secretes releasing hormones that control the release of other hormones by the pituitary gland Endocrine cells inside the pancreas that secrete hormones (glucagon and insulin) that aid carbohydrate (sugar) metabolism Paired female reproductive organs that produce hormones and release oocyte (egg cells) Four small glands embedded on the posterior surface of the thyroid gland that regulate calcium and phosphorus levels in the bloostream Small cone-shaped gland located in the brain that secretes melatonin, which affects sleep-wake cycles and reproduction Pea-sized gland located at the base of the brain that secretes hormones that stimulates the function of other endocrine glands Male reproductive glands, located in the scrotum, that produce sperm and testosterone Gland in the mediastinum (membranous partition in the thoracic cavity) that secretes thymosin, a hormone that regulates the immune system Bilobed gland located in the neck that secretes thyroid hormone that is needed for cell growth and metabolism; the largest endocrine gland; has two lobes connected by a tissue called the isthmus Targets the adrenal cortex; stimulates secretion of corticosteroids Targets the ovaries and testes; stimulates secretion of estrogen in females and testosterone in males Targets bones and other tissues; stimulates protein synthesis and body growth Targets the ovaries and testies; stimulates secretion of progesterone in females and testosterone in males Targets breast tissue; stimulates mi
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A Glossary Of Key Diabetes Terms

Learning that you have diabetes can be overwhelming — with lifestyle changes, new medications, and the variety of tests needed to stay healthy. One stumbling block for anybody managing a chronic condition can be the vocabulary of medical terms. Here's a glossary of some of the most common diabetes terms you need to know. A1C: a test that reveals exactly how well your blood sugar (glucose) has been controlled over the previous three months. Beta cells: cells found in the pancreas that make insulin. Blood glucose: also known as blood sugar, glucose comes from food and is then carried through the blood to deliver energy to cells. Blood glucose meter: a small medical device used to check blood glucose levels. Blood glucose monitoring: the simple blood test used to check the amount of glucose in the blood; a tiny drop of blood, taken by pricking a finger, is placed on a test strip and inserted in the meter for reading. Diabetes: the shortened name for diabetes mellitus, the condition in which the pancreas doesn’t produce enough insulin or your body is unable to use insulin to move glucose into cells of the body. Diabetic retinopathy: the eye disease that occurs in someone with diabetes when the small blood vessels of the retina become swollen and leak liquid into the retina, blurring vision; it can sometimes lead to blindness. Gestational diabetes: the diabetes some women develop during pregnancy; it typically subsides after the baby is delivered, but many women who have had gestational diabetes may develop type 2 diabetes later in life. Glucagon: the hormone that is injected into a person with diabetes to raise their blood glucose level when it's very low (hypoglycemia). Glucose: blood sugar that gives energy to cells. Hyperglycemia: also known as high blood glucose, th
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Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in
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Diabetic Ketoacidosis (dka)

Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services, as detailed here and in this guideline. Preparations should also be made for the transition from paediatric to adult services, which have a somewhat different model of care and evidence base. Rapid‐acting insulin analogues (artificial insulin such as insulin lispro, insulin aspart, or insulin glulisine) act more quickly than regular human insulin. In people with a specific type of life‐threatening diabetic coma due to uncontrolled diabetes, called diabetic ketoacidosis, prompt administration of intravenous regular insulin is standard therapy. The rapid‐acting insulin analogues, if injected subcutaneously, act faster than subcutaneously administered regular insulin. The need for a continuous intravenous infusion, an intervention that usually requires admission to an intensive care unit, can thereby be avoided. This means that subcutaneously given insulin analogues for diabetic ketoacidosis might be applied in the emergency department and a general medicine ward. Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the preventio
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How Dka Happens And What To Do About It

Certified Diabetes Educator Gary Scheiner offers an overview of diabetic ketoacidosis. (excerpted from Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin by Gary Scheiner MS, CDE, DaCapo Press, 2011) Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you. The primary cause of DKA is a lack of working insulin in the body. Most of the body’s cells burn primarily sugar (glucose) for energy. Many cells also burn fat, but in much smaller amounts. Glucose happens to be a very “clean” form of energy—there are virtually no waste products left over when you burn it up. Fat, on the other hand, is a “dirty” source of energy. When fat is burned, there are waste products produced. These waste products are called “ketones.” Ketones are acid molecules that can pollute the bloodstream and affect the body’s delicate pH balance if produced in large quantities. Luckily, we don’t tend to burn huge amounts of fat at one time, and the ketones that are produced can be broken down during the process of glucose metabolism. Glucose and ketones can “jump into the fire” together. It is important to have an ample supply of glucose in the body’s cells. That requires two things: sugar (glucose) in the bloodstream, and insulin to shuttle the sugar into the cells. A number of things would start to go wrong if you have no insulin in the bloodstream: Without insulin, glucose cannot get into the body’s cells. As a result, the cells begin burning large amounts of fat for energy. This, of course,
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